Alexandra Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People and their relatives were involved in planning and making shared decisions about their care and treatment. Care plans provided guidance for staff on how to provide care and support to people. Staff were open and friendly with us whilst we were on site. Managers and staff worked well with other healthcare professionals but were aware there were further improvements needed in some areas. There were policies and procedures in place to ensure people were treated with respect and staff followed human rights principles as well as ensuring the service maintained confidential personal information and records in line with national guidance and legal requirements

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Risks to people had been assessed and were reviewed regularly. Care plans were in place, which included people's needs and preferences. One family told us due to recent sudden changes in their relatives health, they were involved in a video call to discuss the next steps.

The registered manager explained how they ensure people's views are included in their pre-assessment, and throughout the development of the care plan. There was also a focus on ensuring any protected characteristics, such as ethnicity or religious preferences were adhered to. Staff told us the care plans were detailed and provided them with the guidance they required to provide the right care for reach individual. Through observation and discussion with the management team it was evident that they wanted to provide a good quality, person centered service.

We saw care plans and daily notes that were recorded online and were reflective of people’s individual needs. We saw where updates were made, following any changes in people’s health or care status. People’s needs were considered and care plans were detailed enough to provide all guidelines for staff in areas such as communication, medical history, mental capacity sexuality and activities and interests.

People did not raise any specific concerns about access to care provision and services. One relative told us they had pushed for additional professional support, this had now happened, and they were happy with the outcome. We saw records that confirmed care and treatment overall, was delivered in a way which met people’s different health and social care needs.

The registered manager and staff demonstrated they were aware of people’s religious beliefs as well as their care and treatment needs. Feedback from staff was mixed. Three staff indicated they did not feel they had sufficient time to fully read people’s care plans, or if they did it was a very rushed thing. Other care staff advised they did have time to read such plans and several others did not mention this as a concern at all.

Feedback from external professionals was mixed. There were concerns raised of difficulties at times when requesting information, or when subsequent actions had not always been carried out as directed. Two professionals had commented that people had not always received an appropriate response to their health needs, for example, “Staff’s ability to recognise distressing symptoms, is not always consistent,” and “Where new medication was prescribed, not being swiftly chased, meaning patients were not on their new medication”.

People’s records showed they received input from various health and social care professionals. The registered manager explained that they followed up issues when these were raised. They record where decisions have been made or when things are changing and follow up and report back to external agencies if needed. They explained this was an area where they were striving to improve relationships.

People and their families told us they had received the information they needed about their care and the service.

Staff who did not speak English as a first language, told us, information and guidance had been translated into their own language to assist them to complete their duties, and help with breaking the language barrier. Staff told us the management team were good at sharing information with them. The registered manager explained how people (and/or their relatives) were given detailed information as part of the pre-admission assessment process. The registered manager explained they have both people and staff who speak a range of languages, and told us they had translated information and made sure people understood this.

The provider was able to supply documents that were translated to help make sure people using the service and their families had the information they needed. The provider told us they had made adjustments for staff, offering additional support to ensure they had access to training and information. There was a quarterly newsletter to share information about the service and regular meetings for people living there and their relatives. One professional shared how, ““The staff and manager have always been always approachable and welcoming, and happy to support with providing me with care plan information etc.”

People were informed and supported to raise any concerns about their care and to make complaints. People were given a copy of the complaints procedure on admission and encouraged to raise any concerns in their resident representative meetings, or via a discussion with the registered manager. No one we spoke with had raised concerns and felt that they weren’t listened to, however, one family member shared how they had to escalate their concern and had to push for a response.

The registered manager explained how people (and/or their relatives) were given information as part of the pre-admission assessment process. They also gave an example of how they support a person whose first language is not English and who also has dementia, to be involved in decision making. The registered manager told us any complaints received, were listened to and would be acted upon. They also explained how they had addressed the culture of some staff, in ensuring they adhered to company values, They advised they had to address competency considerations in order to identify if further development, or support was required. We had received mixed feedback from staff which could relate to these areas.

Staff meetings were held quarterly, where staff could raise any concerns or there is a Suggestions box in the reception area. Staff were encouraged to raise concerns directly or with the operations manager whose details were readily available. The complaints procedure, and arrangements for regular meetings, helped to ensure this was promoted. Any raised complaints or concerns, were recorded via a tracker, to help inform and make any improvements where needed.

People were supported to access appropriate care, including those living with dementia, mental health, physical disability, and sensory impairments. We saw no concerns with people accessing the environment or services which suited their individual needs; the providers statement of purpose explained how they supported the ‘cultural, spiritual, emotional, social and ethnic needs’ of the people living there.

Staff were aware of people’s right to equity in accessing care, treatment, and support. They understood how discrimination could disadvantage access to care, treatment, and support. Staff were aware of people’s protected characteristics and knew how to tailor support depending on the individual’s needs.

There had been mixed feedback from professionals; some were positive, such as ensuring information about incidents are escalated promptly, “The staff are reactive to any incidents with my clients, and ensure they inform us immediately should they experience any problems.” Others noted how there could be a delay in accessing specific services such as failing to chase an outpatient appointment.

The provider holds a sponsorship licence which means some staff can be recruited from abroad. They advised they offer translation of documents if needed and can produce easy to read notices and larger print if required. The provider had an equality, diversity and inclusion policy setting out how peoples’ diverse needs and human rights needed to be upheld. Staff were provided with access to policies and procedures, and received training about equality and diversity, as part of their induction and ongoing training. There was also included in the safeguarding policy information about discriminatory abuse, important as there was a diverse staff team as well as people in the service.

People and visitors told us they were happy with the service. People, relatives and visitors were invited to give feedback about their experiences.

Through our observation and discussions with the registered manager and provider it was evident that they wanted to provide a good quality service and we saw no evidence of any inequity in experience and outcomes.

People’s needs were considered, and communication needs assessed and recorded as part of the care planning process. Care records contained sufficient guidance for staff to offer emotional support for the person. Care plans were person centred and considered all aspects of a persons life, including, sexuality, medical history, mental capacity, activities and interests.

People have end of life care plans in place as part of their routine plans. However, there had been some difficulties in getting families to engage in this process. The registered manager was looking for ways of increasing the input from families, but appreciated this is a sensitive subject.

Staff told us they had received training to improve their knowledge and skills, in relation to care planning, and having uncomfortable conversations about death and dying. Care plans we saw contained information about how people wanted to be supported and receive care at the end of their life. The service also had access to the hospice service for further support if needed.

We saw where consideration was given to inform end of life care plans, to include people’s choices, ensuring comfort and dignity wishes were recorded. We also viewed the emergency plans in place, to ensure people were individually supported in case of a fire, or any other event, which may require evacuation. The registered manager had reflected on where service improvements were needed and developed an action plan. We saw improvements had already been made, and plans were in place for further improvements in the service.